| NPI | 1801289772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANIEKA GAUSE Owner 843-467-4319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: SC 201403) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2015-03-16 |